Hyperalimentation hypophosphatemia: hematologic neurologic dysfunction due to ATP depletion

A hypophosphatemic syndrome which occurs in hyperalimented humans can be reproduced in starved dogs and can be corrected by phosphate repletion. The authors demonstrated that the hypophosphatemia severely depresses adenine nucleotides in red cells, platelets and leukocytes, resulting in their shortened survival, diminished function and abnormal hydration. They suggest that an analogous alteration in volume control of brain cells produced cerebral swelling, coma and frequently death. They urge that serum phosphorus levels be rigorously maintained in hyperalimented individuals to prevent the disastrous consequences described in these studies.